tbuckley/cabot-search huggingface dataset:
Making the Right Diagnosis: Slowly but Surely
Authors: Parag R. Gajendragadkar, Claire A. Martin, Rohan S. Wijesurendra
Journal: Circulation (2023)

An 84-year-old man with severe ischemic cardiomyopathy and a dual chamber implantable cardioverter defibrillator with previous treatment for sustained ventricular arrhythmias presented after feeling generally unwell for 4 days.There was no history of chest pain, dyspnea, palpitation, or syncope.On examination, he was alert and oriented, afebrile, and with a blood pressure 110/70 mm Hg.The remainder of the clinical examination was normal with no evidence of fluid overload.The ECG shown in Figure 1 was recorded, and he was admitted to the ward for further investigation and treatment.What is the diagnosis?Please turn the page to read the diagnosis.
Epitranscriptomic Modification of MicroRNA Increases Atherosclerosis Susceptibility
Authors: Ming He, Jianjie Dong, Junmao Wen, Yuqing Zhang, So Yun Han, Chen Wang, Brendan Gongol, Tong-You Wade Wei, Jian Kang, Hsi-Yuan Huang, Susan Cheng, John Y-J. Shyy
Journal: Circulation (2023)
Alterations in gut virome are associated with cognitive function and minimal hepatic encephalopathy cross-sectionally and longitudinally in cirrhosis
Authors: Thananya Jinato, Masoumeh Sikaroodi, Andrew Fagan, Richard K Sterling, Hannah Lee, Puneet Puri, Brian C Davis, Michael Fuchs, Edith Gavis, Patrick M Gillevet, Jasmohan S Bajaj
Journal: Gut Microbes (2023)

Cognitive dysfunction due to minimal hepatic encephalopathy (MHE) adversely impacts patients with cirrhosis and more precise therapies are needed. Gut-brain axis changes are therapeutic targets, but prior studies have largely focused on bacterial changes. Our aim was to determine linkages between individual cognitive testing results and bacteria with the virome using a cross-sectional and longitudinal approach. We included cross-sectional (n = 138) and longitudinal analyses (n = 36) of patients with cirrhosis tested using three cognitive modalities, which were psychometric hepatic encephalopathy score (PHES), inhibitory control test (ICT), Stroop, and all three. Stool metagenomics with virome and bacteriome were analyzed studied cross-sectionally and in a subset followed for development/reversal of MHE repeated at 6 months (longitudinally only using PHES). Cross-sectional: We found no significant changes in α/β diversity in viruses or bacteria regardless of cognitive testing. Cognitively impaired patients were more likely to have higher relative abundance of bacteriophages linked with Streptococcus, Faecalibacterium, and Lactobacillus, which were distinct based on modality. These were also linked with cognition on correlation networks. Longitudinally, 27 patients remained stable while 9 changed their MHE status. Similar changes in phages that are linked with Streptococcus, Faecalibacterium, and Lactobacillus were seen. These phages can influence ammonia, lactate, and short-chain fatty acid generation, which are neuro-active. In conclusion, we found linkages between bacteriophages and cognitive function likely due to impact on bacteria that produce neuroactive metabolites cross-sectionally and longitudinally. These findings could help explore bacteriophages as options to influence treatment for MHE in cirrhosis.
Loss of claudin-3 expression increases colitis risk by promoting Gut Dysbiosis
Authors: Rizwan Ahmad, Balawant Kumar, Ishwor Thapa, Geoffrey A. Talmon, Jeffrey Salomon, Amanda E. Ramer-Tait, Dhundy K. Bastola, Punita Dhawan, Amar B. Singh
Journal: Gut Microbes (2023)

Dysregulation of both the gut barrier and microbiota (dysbiosis) promotes susceptibility to and severity of Inflammatory Bowel Diseases (IBD). Leaky gut and dysbiosis often coexist; however, potential interdependence and molecular regulation are not well understood. Robust expression of claudin-3 (CLDN3) characterizes the gut epithelium, and studies have demonstrated a positive association between CLDN3 expression and gut barrier maturity and integrity, including in response to probiotics. However, the exact status and causal role of CLDN3 in IBD and regulation of gut dysbiosis remain unknown. Analysis of mouse and human IBD cohorts helped examine CLDN3 expression in IBD. The causal role was determined by modeling CLDN3 loss of expression during experimental colitis. 16S sequencing and in silico analysis helped examine gut microbiota diversity between Cldn3KO and WT mice and potential host metabolic responses. Fecal microbiota transplant (FMT) studies were performed to assess the role of gut dysbiosis in the increased susceptibility of Cldn3KO mice to colitis. A significant decrease in CLDN3 expression characterized IBD and CLDN3 loss of expression promoted colitis. 16S sequencing analysis suggested gut microbiota changes in Cldn3KO mice that were capable of modulating fatty acid metabolism and oxidative stress response. FMT from naïve Cldn3KO mice promoted colitis susceptibility in recipient germ-free mice (GFM) compared with GFM-receiving microbiota from WT mice. Our data demonstrate a critical role of CLDN3 in maintaining normal gut microbiota and inflammatory responses, which can be harnessed to develop novel therapeutic opportunities for patients with IBD.
Discovery of a potent and selective cell division cycle 7 inhibitor from 6-(3-fluoropyridin-4-yl)thieno[3,2-d]pyrimidin-4(3H)-one derivatives as an orally active antitumor agent
Authors: Mingwei Fu, Min Ge, Wanxiang Yang, Chunchen Hu, Xiaowei Li, Yuanjiang Wang, Shaohua Gou
Journal: Acta Pharmaceutica Sinica B (2023)
Multi-omics analyses demonstrate the modulating role of gut microbiota on the associations of unbalanced dietary intake with gastrointestinal symptoms in children with autism spectrum disorder
Authors: Hailin Li, Churui Liu, Saijun Huang, Xin Wang, Muqing Cao, Tingfeng Gu, Xiaoxuan Ou, Shuolin Pan, Zongyu Lin, Xiaotong Wang, Yanna Zhu, Jin Jing
Journal: Gut Microbes (2023)

Our previous work revealed that unbalanced dietary intake was an important independent factor associated with constipation and gastrointestinal (GI) symptoms in children with autism spectrum disorder (ASD). Growing evidence has shown the alterations in the gut microbiota and gut microbiota-derived metabolites in ASD. However, how the altered microbiota might affect the associations between unbalanced diets and GI symptoms in ASD remains unknown. We analyzed microbiome and metabolomics data in 90 ASD and 90 typically developing (TD) children based on 16S rRNA and untargeted metabolomics, together with dietary intake and GI symptoms assessment. We found that there existed 11 altered gut microbiota (FDR-corrected P-value <0.05) and 397 altered metabolites (P-value <0.05) in children with ASD compared with TD children. Among the 11 altered microbiota, the Turicibacter, Coprococcus 1, and Lachnospiraceae FCS020 group were positively correlated with constipation (FDR-corrected P-value <0.25). The Eggerthellaceae was positively correlated with total GI symptoms (FDR-corrected P-value <0.25). More importantly, three increased microbiota including Turicibacter, Coprococcus 1, and Eggerthellaceae positively modulated the associations of unbalanced dietary intake with constipation and total GI symptoms, and the decreased Clostridium sp. BR31 negatively modulated their associations in ASD children (P-value <0.05). Together, the altered microbiota strengthens the relationship between unbalanced dietary intake and GI symptoms. Among the altered metabolites, ten metabolites derived from microbiota (Turicibacter, Coprococcus 1, Eggerthellaceae, and Clostridium sp. BR31) were screened out, enriched in eight metabolic pathways, and were identified to correlate with constipation and total GI symptoms in ASD children (FDR-corrected P-value <0.25). These metabolomics findings further support the modulating role of gut microbiota on the associations of unbalanced dietary intake with GI symptoms. Collectively, our research provides insights into the relationship between diet, the gut microbiota, and GI symptoms in children with ASD.
Axin1‘s mystique in manipulating microbiome amidst colitis
Authors: Shari Garrett, Monica C. Asada, Jun Sun
Journal: Gut Microbes (2023)

Classically, Axin1 is considered a regulator of Wnt/β-catenin signaling. However, Axin1’s roles in host-microbial interactions have been unknown. Our recent study has demonstrated that deletion of intestinal epithelial Axin1 in epithelial cells and Paneth cells protects the host against colitis by enhancing Akkermansia muciniphila. Loss of intestinal epithelial or Paneth cell Axin1 results in increased Wnt/β-catenin signaling, proliferation, and cell migration. This is associated with morphologically altered goblet and Paneth cells, including increased Muc2 and decreased lysozyme. Axin1 deletion specifically enriched Akkermansia muciniphila. Akkermansia muciniphila in Axin1 knockout mice is the driver of protection against DSS-induced inflammation. Here, we feature several significant conceptual changes, such as differences between Axin1 and Axin2, Axin1 in innate immunity and microbial homeostasis, and Axin1 reduction of Akkermansia muciniphila. We discuss an important trend in the field related to Paneth cells and tissue-specific Axin1 manipulation of microbiome in health and inflammation.
There Is Only One Sphere of Morality
Authors: Michael Nair-Collins
Journal: The American Journal of Bioethics (2023)

Click to increase image sizeClick to decrease image sizeThis article refers to:Spheres of Morality: The Ethical Codes of the Medical Profession DISCLOSURE STATEMENTNo potential conflict of interest was reported by the author(s).Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.
FOXP1 and KLF2 reciprocally regulate checkpoints of stem-like to effector transition in CAR T cells
Authors: Ziang Zhu, Guohua Lou, Xiao-Lu Teng, Haixia Wang, Ying Luo, Wangke Shi, Kiddist Yihunie, Shumeng Hao, Kole DeGolier, Chengheng Liao, Huocong Huang, Qing Zhang, Terry Fry, Tao Wang, Chen Yao, Tuoqi Wu
Journal: Nature Immunology (2023)
A second-generation M1-polarized CAR macrophage with antitumor efficacy
Authors: Anhua Lei, Hua Yu, Shan Lu, Hengxing Lu, Xizhong Ding, Tianyu Tan, Hailing Zhang, Mengmeng Zhu, Lin Tian, Xudong Wang, Siyu Su, Dixuan Xue, Shaolong Zhang, Wei Zhao, Yuge Chen, Wanrun Xie, Li Zhang, Yuqing Zhu, Jing Zhao, Wenhong Jiang, George Church, Francis Ka-Ming Chan, Zhihua Gao, Jin Zhang
Journal: Nature Immunology (2023)
Virtue Ethics and the Spheres of Morality Framework
Authors: Christopher Bobier
Journal: The American Journal of Bioethics (2023)

"Virtue Ethics and the Spheres of Morality Framework." The American Journal of Bioethics, 23(12), pp. 37–38This article refers to:Spheres of Morality: The Ethical Codes of the Medical Profession DISCLOSURE STATEMENTNo potential conflict of interest was reported by the author(s).Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.
Varieties of Citizen Engagement in Deliberation about Biotechnology
Authors: Michael A. Neblo, Avery White
Journal: The American Journal of Bioethics (2023)

Click to increase image sizeClick to decrease image sizeThis article refers to:Public Engagement through Inclusive Deliberation: The Human Genome International Commission and Citizens’ JuriesThis article is referred to by:Response to Open Peer Commentaries on “Public Engagement through Inclusive Deliberation: The Human Genome International Commission and Citizens’ Juries” DISCLOSURE STATEMENTNo potential conflict of interest was reported by the author(s).Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.
A Wide Wide QRS
Authors: Mazen M. Kawji
Journal: JAMA Internal Medicine (2023)

This case report describes a patient in their 70s with shortness of breath and generalized weakness and a history of coronary artery bypass surgery, ischemic cardiomyopathy, a dual-chamber defibrillator, paroxysmal atrial fibrillation, and kidney failure while undergoing hemodialysis.
Characteristics and Obtainment Methods of Firearms Used in Adolescent School Shootings
Authors: Brent R. Klein, Jeff Trowbridge, Cory Schnell, Kirstin Lewis
Journal: JAMA Pediatrics (2023)

Importance Within gun violence research, the types of firearms involved in US school shootings and the origins of these weapons have not been well explored. Objective To examine the type, make, and power of firearms involved in school-related gun violence as well as the sources and methods through which adolescents obtained these weapons. Design, Setting, and Participants This cross-sectional study used descriptive statistics and logistic regression to analyze 253 school shootings executed by 262 adolescents (aged ≤19 years) in the US from January 1, 1990, to December 31, 2016, and to calculate adjusted estimates for missing cases. The data were sourced from The American School Shooting Study (TASSS), which compiles information about these shooting events from open-source materials. Data analysis was performed from June 23, 2023, to July 20, 2023. Exposures Firearm type, make, and power. Main Outcomes and Measures The firearm type refers to whether a weapon was a handgun, rifle, or shotgun. The firearm’s make differentiates semiautomatic or fully automatic guns from other action mechanisms. The firearm’s power refers to the caliber and velocity, distinguished as small, moderate, or higher power. The acquisition source captures from whom the firearm was received. The obtainment method refers to how the shooter obtained the firearm. Estimates were adjusted by total number of documents and TASSS reliability score as well as neighborhood demographic, socioeconomic, and land use variables measured at the census tract level, and were weighted to account for item nonresponse. Results A total of 262 adolescents (mean [SD] age, 16.2 [1.9] years; 256 [97.8%] male) were studied. In the adjusted analyses, handguns were the most used weapon in school shootings (85.5%; 95% CI, 80.6%-89.4%). Firearms were predominantly lower (37.0%; 95% CI, 29.9%-44.7%) or moderate (39.7%; 95% CI, 32.0%-47.8%) in power. Adolescents mainly obtained their guns from relatives (41.8%; 95% CI, 31.7%-52.6%), friends or acquaintances (22.0%; 95% CI, 13.2%-34.5%), the illegal market (29.6%; 95% CI, 19.3%-42.5%), strangers or persons who were shot (4.7%; 95% CI, 1.8%-11.6%), or licensed dealers (1.9%; 95% CI, 0.7%-5.2%). Most firearms were procured via theft from relatives (82.1%; 95% CI, 69.4%-90.3%). Conclusions and Relevance Despite the more frequent use of lower to moderately powered firearms in school shootings, this study’s results indicated stability in the use of high-powered weapons in adolescent school shootings throughout the research timeframe. A majority of the firearms were procured from the perpetrator’s family or relatives or from friends or acquaintances. These findings may significantly influence discussions around gun control policy, particularly in advocating for secure firearm storage to reduce adolescents’ access to weapons.
Video Education in Early Pregnancy and Parent Knowledge of Neonatal Resuscitation Options
Authors: Siobhan M. McDonnell, Kathryn E. Flynn, Jennifer J. McIntosh, Ruta Brazauskas, U. Olivia Kim, S. Iqbal Ahamed, Mir A. Basir
Journal: JAMA Network Open (2023)

This secondary analysis of a randomized clinical trial investigates the proportion of correct answers on neonatal resuscitation options among parents after seeing a video on these options.
Testing for Cytomegalovirus Among Individuals Who Were Immunocompromised, 2018-2022
Authors: Purva Jain, Sandeep Basnet, Sahar Syed, Brent Arakaki, Katherine E. Mues, Zachary A. Marcum, John Diaz-Decaro
Journal: JAMA Network Open (2023)

This cohort study investigates rates of cytomegalovirus testing before and during the COVID-19 pandemic among individuals who were immunocompromised.
Public Engagement with Human Germline Editing Requires Specification
Authors: Boy Vijlbrief, Sam Riedijk, Eline M. Bunnik
Journal: The American Journal of Bioethics (2023)

Click to increase image sizeClick to decrease image sizeThis article refers to:Public Engagement through Inclusive Deliberation: The Human Genome International Commission and Citizens’ JuriesThis article is referred to by:Response to Open Peer Commentaries on “Public Engagement through Inclusive Deliberation: The Human Genome International Commission and Citizens’ Juries” DISCLOSURE STATEMENTNo potential conflict of interest was reported by the author(s).Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.
Against the Equality of Moral Spheres in Healthcare
Authors: Jonathan Herington, Lainie Friedman Ross
Journal: The American Journal of Bioethics (2023)

Click to increase image sizeClick to decrease image sizeThis article refers to:Spheres of Morality: The Ethical Codes of the Medical Profession ACKNOWLEDGEMENTSThe project described in this publication was supported by the University of Rochester CTSA award number 3 UL1 TR002001 – 08S1 from the National Center for Advancing Translational Sciences of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.DISCLOSURE STATEMENTNo potential conflict of interest was reported by the author(s).Notes1 Doernberg and Truog distinguish between “human subjects research” and “scientific knowledge,” but do not clearly articulate the distinct ends of these spheres, instead simply claiming that “the norms of clinical research govern the relationship between investigators and human subjects” and “scientific norms relate to the integrity of the scientific process.” On our view, when physicians act in either sphere they are oriented towards the production of generalizable knowledge about human health and/or healthcare—and almost all cases of conflict that physicians’ encounter between the sphere of clinical care and either “human subject research” or “scientific knowledge” (e.g. equipoise, research recruitment, biobanking, expanded access, etc.) are cases best understood as driven by a tension between caring for the patient in front of you and the goal of producing socially useful knowledge.
Dual targeting of cancer metabolome and stress antigens affects transcriptomic heterogeneity and efficacy of engineered T cells
Authors: Patricia Hernández-López, Eline van Diest, Peter Brazda, Sabine Heijhuurs, Angelo Meringa, Lauren Hoorens van Heyningen, Caterina Riillo, Caroline Schwenzel, Marina Zintchenko, Inez Johanna, Mara J. T. Nicolasen, Astrid Cleven, Thomas A. Kluiver, Rosemary Millen, Jiali Zheng, Froso Karaiskaki, Trudy Straetemans, Hans Clevers, Remco de Bree, Hendrik G. Stunnenberg, Weng Chuan Peng, Jeanine Roodhart, Susana Minguet, Zsolt Sebestyén, Dennis X. Beringer, Jürgen Kuball
Journal: Nature Immunology (2023)
Potential Medicare and Medicaid Savings on Anti-CD20 Therapy for Multiple Sclerosis
Authors: John Kim, Aaron S. Kesselheim, Riley Bove, Jerry Avorn, Benjamin N. Rome
Journal: JAMA Neurology (2023)

This cross-sectional study compares price data for ocrelizumab and rituximab to estimate the savings to Medicare and Medicaid if rituximab were used in the treatment of multiple sclerosis instead of the higher-priced ocrelizumab.
A Young Woman With Hypertonia, Severe Scoliosis, and Encephalopathy
Authors: Lei Hua, Yang Zhao, Yong-Shen Han
Journal: JAMA Neurology (2023)

A 31-year-old woman was seen with contractures in her fingers and toes, carpal inversion, dysarthria, dysphagia, hypertonia, decreased tendon reflexes, absence of Babinski sign, and no psychiatric problems and significant global atrophy. What is your diagnosis?
Ethics at the Edges: Normative Considerations When Spheres of Morality Overlap
Authors: D. Micah Hester
Journal: The American Journal of Bioethics (2023)

Click to increase image sizeClick to decrease image sizeThis article refers to:Spheres of Morality: The Ethical Codes of the Medical Profession DISCLOSURE STATEMENTNo potential conflict of interest was reported by the author(s).Notes1 Following London (Citation2007), I take many of these accounts to misconstrue the context of research.2 This does not speak to whether or not clinical equipoise is a valid moral norm. While I agree with London’s “integrative approach” (2007) to research ethics and his support of clinical equipoise as a valid moral norm, Truog and others (cited in Dornberg and Truog Citation2023) disagree using strong arguments. But that there is controversy over the acceptability of a moral norm is not unique to the concept of “clinical equipoise”; many of our moral norms in any of the spheres can be scrutinized and even eliminated (cf., the many challenges to the principle of “respect for autonomy” or concerns with the “best interests standard” in pediatrics).Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.
Child Welfare Youth—Psychotropic Use and Implications
Authors: Kevin M. Simon
Journal: JAMA Pediatrics (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
Discrepancies in Estimating Excess Death by Political Party Affiliation During the COVID-19 Pandemic
Authors: Christopher Dasaro, Alyson Haslam, Vinay Prasad
Journal: JAMA Internal Medicine (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal